Eczema is a dermatological disease caused by a lack of sebum and skin hydration. Normal skin is able to maintain a balance between these factors on its own, creating a protective barrier against environmental damage, irritation and infection. Scalp eczema, in particular, could be caused by both atopic (hereditary) and seborrheic dermatitis. It is sometimes called dandruff, seborrheic eczema, seborrheic psoriasis and, in infants, cradle cap; these types of dermatitis can also cause eczema on the face, chest, back, armpits and groin. Although it is a disorder that causes a lot of discomfort and embarrassment, it is non-contagious and is not caused by poor personal hygiene. In order to treat or resolve your scalp eczema you need to understand its causes and symptoms.
Steps
Method 1 of 4: Recognize the Symptoms and Causes
Step 1. Look for common symptoms
Scalp eczema can cause problems on the head and also on other areas affected by the disorder. The most common symptoms are peeling (dandruff), itching, skin redness, crusting or scaling on the skin, greasy areas and alopecia.
- Inflammation leads to the development of reddened areas with a high concentration of fatty acids, which in some people give the skin a greasy and yellowish appearance.
- In infants, eczema is quite common on the scalp and occurs in the form of red, dry, scaly patches or, in severe cases, as a thick white or yellow and oily crust.
- Some dermatological diseases such as mycoses, psoriasis, dermatitis and lupus can resemble this ailment. However, a differential diagnosis can be made based on the areas of the body on which they occur and the number of skin layers involved.
- If you are unsure whether your symptoms fall within the scope of eczema, see your doctor. He will be able to determine the cause of the disorder and evaluate its severity, to decide on a possible therapy.
Step 2. Learn about the causes of eczema
Some doctors believe that, in addition to reducing the production of sebum and skin moisture, eczema can also be triggered in some way by a certain type of yeast: Malassezia furfur. This is normally present on the outer surface of human skin but, in people suffering from scalp eczema, yeast invades the surface layers of the skin and secretes substances that increase the production of fatty acids. This triggers an inflammatory reaction and makes the skin dry, which starts peeling.
If you suffer from atopic eczema, i.e. there is a genetic tendency in your family to develop this disease, yeast may not be one of the causes. Doctors believe that individuals who develop this dermatitis have a weakened skin barrier due to a gene mutation within the skin's structural proteins
Step 3. Determine your risk factors
Although medical science is uncertain as to why some patients develop seborrheic dermatitis and others do not, there appear to be some factors that increase the likelihood of suffering from it:
- Being obese or overweight
- Fatigue;
- Environmental factors (very dry climate, for example);
- Stress;
- Other dermatological diseases (such as acne);
- Some systemic diseases such as stroke, HIV, Parkinson's disease or head trauma.
Step 4. Avoid skin and hair products that contain alcohol
This element removes the protective sebum layer causing dryness of the scalp. All of this only makes the flaking and itching worse and could turn out to be a cause of seborrheic eczema.
Proceed gently when washing your scalp and hair! Gently massage with your fingers while shampooing: the goal is to wash your hair without removing the sebum from the scalp
Step 5. Don't scratch your itchy spots
While it's not easy to avoid it when you feel itchy, you should try not to scratch the inflamed areas, otherwise they could become more irritated and bleed.
It could also trigger a secondary infection if you scratch excessively
Step 6. Know that eczema will still manifest itself
It is quite unlikely that you will be able to "recover" completely from this disorder, even with effective treatment. Scalp eczema appears and then disappears when treated; however, relapses are frequent, so the therapy is almost continuous. Fortunately, most treatments can be continued for a long time.
Method 2 of 4: Treating Adult Eczema with Over-the-Counter Products
Step 1. First discuss your problem with your doctor or pharmacist
Non-prescription drugs can interfere with some diseases and other therapies, so it is always advisable to evaluate these risks with a professional before undergoing treatment.
- If you suffer from allergies, systemic conditions, take medications, are pregnant or breastfeeding, then you should always consult with your doctor before starting any type of treatment.
- Do not give any therapy to children without first consulting a pediatrician. Treatment of scalp eczema in children follows a different procedure and is not covered in this section of the article.
Step 2. Rely on over-the-counter treatments
You can find several shampoos and oils on the market that are indicated to solve eczema problems and that do not require a prescription. These are usually the first products that are recommended and used before switching to prescription shampoos. You can use them daily for a long time.
Remember that these products are not approved for pediatric use! Use them only to treat eczema in adults
Step 3. Wash your hair properly
Regardless of the shampoo you use, there are some general tips you should follow when washing your hair with any product or oil. If you scrub your scalp too vigorously or use cleansers that contain alcohol, your skin problem will get worse.
- First, wet your hair with warm (not hot) water.
- Apply the medicated cleanser all over the scalp and hair, massaging gently. Do not scratch or rub the skin, as this could cause the scabs to bleed and trigger an infection.
- Leave the product to act for the period indicated on the package; usually you have to wait five minutes.
- Rinse your head thoroughly with warm (not hot) water and pat dry with a clean cloth.
- Shampoos that contain mineral tar are dangerous if ingested: prevent foam from getting into your eyes or mouth.
- Some products, such as ketoconazole shampoos, can be effective when alternating twice a week with other scalp cleansers.
Step 4. Wash your hair with a selenium sulfide shampoo
This product is capable of killing the yeast which is potentially responsible for many cases of eczema. If you can get rid of the yeast, your skin has a chance to heal without making the dryness, inflammation and itchy scabs worse.
- The most common side effects of these cleansers are dryness or greasiness of the scalp and the hair itself. In a very small percentage, some patients have experienced irritation, discoloration and hair loss.
- You must continue the treatment for at least two weeks if you want to see results.
Step 5. Apply a tea tree product to your hair
Tea tree oil has natural antifungal properties that are helpful in curing eczema. A clinical study has shown that some patients have benefited from using a shampoo with 5% tea tree oil. The only side effect is scalp irritation.
- You can use this product every day.
- Tea tree oil is toxic if ingested; therefore prevents it from getting into your mouth or eyes.
- In addition, this product has estrogenic and antiandrogenic properties and has been linked to conditions such as breast growth in pre-adolescent males.
Step 6. Massage the scalp with egg oil
Contains natural immunoglobulins that help treat eczema when used regularly.
- This product should be used twice a week, leaving it on overnight for at least a year.
- Egg oil is rich in docosahexaenoic acid (DHA), a semi-essential fatty acid of the omega-3 series, which promotes the growth of new skin cells.
Step 7. Try zinc pyrithione shampoos
Most "anti-dandruff" cleansers contain this active ingredient. Scientists don't know exactly why it's effective against scalp eczema, but it appears to have antibacterial and antifungal properties. It also slows down cell reproduction, reducing peeling. The only known side effect is skin irritation.
- You can use this product three times a week.
- Look for cleaners containing 1 or 2 percent zinc pyrithione; creams are also available.
Step 8. Give salicylic acid shampoos a try
The active ingredient is an exfoliant that eliminates the superficial layers of the skin of the head. The detergents that contain it are effective if the concentration is between 1, 8 and 3%. The only side effect is skin irritation.
Step 9. Try ketoconazole preparations
It is a very effective product for fighting eczema on the head. It is available in many over-the-counter preparations, including shampoos, foams, creams, and gels. There are also preparations that must be prescribed by the doctor.
- Usually, over-the-counter products have lower concentrations of ketoconazole than the shampoos and creams your doctor may prescribe.
- Side effects include abnormal hair texture, discoloration, scalp irritation, dryness or greasiness of the skin and hair.
- Shampoos with 1 or 2% ketoconazole are safe and effective even on infants. You can use them twice a week for two weeks.
Step 10. Apply raw honey
While it's not a shampoo, honey has antibacterial and antifungal properties. You can use it to find relief from itching and loosen scales from the skin. This is obviously not a cure, but it does help the skin heal from injuries.
- Dilute raw honey in hot water, creating a mixture of 90% honey and 10% water.
- Massage the solution into the lesions of the scalp for 2-3 minutes without scratching and without being too aggressive. Finally rinse with warm water.
- Every other day, spread raw honey on the itchy areas and let it sit for 3 hours. After this time, rinse your head. Continue with this procedure for four weeks.
Step 11. Try mineral tar shampoos
The main function of this active ingredient is to slow down the speed with which the skin cells reproduce; it also inhibits fungal proliferation, softens and detaches flaking skin and scabs. However, this is not nearly as harmless as other over-the-counter cleaners and shouldn't be your first choice.
- Use this shampoo twice a day for up to four weeks.
- Possible side effects are itching, localized hair loss, contact dermatitis on the fingers and skin pigmentation changes.
- You should consult your doctor before using a mineral tar shampoo. Do not apply it to children and pregnant or breastfeeding women. It could also negatively interact with some medications and trigger allergic reactions.
Method 3 of 4: Treating Eczema in Infants and Children
Step 1. Wait for the situation to resolve itself
In many infants and young children, scalp eczema clears up on its own within a few weeks - in some cases it may take a few months. Although it may seem like a rather annoying ailment, most children are not bothered by this skin disease.
- If the dermatitis does not heal on its own, see your pediatrician to evaluate a cure.
- Just like in adults, scalp eczema can go away after one treatment and recur later.
Step 2. Use different products for the children
Babies and children under two years of age need different care than adults. Do not use over-the-counter products intended for adult patients.
Step 3. Remove scabs and scales by massaging the scalp
Most of the time, this excess skin can be peeled off with a gentle massage - you can use your fingers or a soft cloth. Moisten the baby's hair with warm water and, with great care, rub his head, but do not scratch it!
Do not use abrasive or exfoliating tools such as bath brushes, vegetable sponges or very hard ones
Step 4. Get a mild baby shampoo
Those that are designed to treat eczema in adults are too aggressive on the delicate skin of babies; for this reason it is best to use a normal baby cleanser such as Aveeno Baby.
- Wash your hair every day.
- Cleansers with 1 or 2% ketoconazole are effective and safe for infants, although you should always consult with your pediatrician before starting treatment. You can use it twice a day for two weeks.
Step 5. Rub his head with oil
If the massage is unable to remove the scabs, then massage the scalp with petroleum jelly or mineral oil, but not olive oil.
- Let the oil soak into the skin for a few minutes, then wash the baby's hair with a mild shampoo. Rinse with warm water and then comb the baby as usual.
- Remember to carefully rinse his scalp after each oil treatment, otherwise the residues will build up and worsen the condition.
Step 6. Bathe the baby
Every 2-3 days you can bathe your baby in warm (not hot) water for no more than 10 minutes.
Avoid irritants like soaps, bubble baths, Epsom salts, or other similar products. They are all potentially irritating to children's skin and can aggravate eczema
Method 4 of 4: Treating Eczema with Prescription Products
Step 1. Discuss prescription products with your doctor
Patients who do not benefit from over-the-counter creams and shampoos or who are dissatisfied with the results may need stronger medications. Your dermatologist may prescribe more aggressive creams, lotions, shampoos, and even systemic medications if medicated shampoos have proven ineffective. There are also treatments that involve the use of UV rays.
Prescription antifungal shampoos and topical corticosteroids are effective but expensive and have several side effects when used for a long time. They are taken into consideration when over-the-counter products do not give the desired results
Step 2. Use anti-fungal shampoos
The most common type of prescription cleanser used in cases of eczema is the antifungal. Usually the choice falls on a product with 1% ciclopirox or with 2% ketoconazole.
- The most common adverse effects for these shampoos are skin irritation, burning sensation, dry skin and itchiness.
- They should be used daily or at least twice a week during the treatment period. Always follow the instructions in the leaflet or the directions of your dermatologist.
Step 3. Try corticosteroid cleansers
These shampoos reduce inflammation, itching and flaking of the scalp. They are usually products that contain 1% hydrocortisone, 0.1% betamethasone, 0.1% clobetasol propionate and 0.01% fluocinolone.
- Adverse reactions occur following prolonged use and include skin thinning, itching, stinging and hypopigmentation of the skin (loss of pigments which occurs with lighter skin). Most patients who use these cleansers for only a limited time do not experience the negative effects.
- These medical shampoos contain steroids which, albeit minimally, are absorbed into the bloodstream. If you have diabetes or are sensitive to cortisone, you should tell your doctor.
- Remember that cortisone shampoos are more expensive than other products.
- You can use them 1-2 times a day during the cure.
- The combined use of an antifungal shampoo and corticosteroids could be safe and lead to better results. Talk to your dermatologist.
Step 4. Get other prescription therapies
Medicated shampoos are generally used to treat scalp eczema. However, there are also creams, lotions, oils and foams that contain one or more of the active ingredients described above.
- Prescription antifungal active ingredients called azoles are very effective against scalp eczema. Among these, the most used is ketoconazole which has shown positive results in many clinical tests.
- Another widely used drug is ciclopirox, a type of hydroxypyridone antifungal. It is available in the form of a gel, cream or liquid solution.
- Corticosteroids are prescribed as both creams and ointments.
Step 5. Try phototherapy
Sometimes light therapy helps with scalp eczema. It is usually prescribed in conjunction with medications, such as psoralen.
- Since phototherapy involves exposure to UV rays, it could increase the risk of skin cancer.
- This type of therapy is reserved for people suffering from eczema caused by atopic dermatitis or for patients with extensive seborrheic dermatitis. It is never used on babies and children.
Step 6. Discuss other solutions with your doctor
There are a few other methods of curing eczema but, generally, they are considered a last resort due to the severe side effects. However, if all previous attempts have failed, you can review these therapies with your dermatologist.
- Creams or lotions that contain tacrolimus (trade name Protopic) and pimecrolimus (trade name Elidel) can be effective. However, they increase the risk of cancer and are much more expensive than corticosteroids.
- Terbinafine (Lamisil) and butenafine (not available in Italy) are oral antifungal drugs that treat scalp eczema. They can interfere with specific enzymes in the body and trigger allergic reactions, as well as cause liver problems. All this limits their use against this skin disease.
